AIDS & Ethics

on much broader interests and institutions. Public strategies can, of
course, be more or less irrational, more or less compatible with what
science reveals about the world. But within the parameters established
by the "facts" there must always remain a realm of uncertainty and of
irreducible choice. Recourse to claims about "scientifically justified
policy"--typical of all parties to disputes about public health policy--
merely deflects attention from the inherent role of competing social
values in the charting of appropriate strategies of social action.
Now that the "natural" alliance between proponents of civil liberties
and the public health has been ruptured, it will be necessary to confront openly questions posed by Lawrence Tribe, the liberal theorist of
jurisprudence, about policy in the face of epidemic challenges. "Who
is being hurt? Who benefits? By what process is the rule imposed? For
what reasons? With what likely effect on precedent" ( Tribe 1978:891)?
How these questions are answered and with what relative weight given
to security and safety on the one hand and to privacy and autonomy on
the other will determine the shape of AIDS policy and will have significant implications for the contours of the United States as a liberal
society in the next years.

ASTHO (Association of State and Territorial Health Officials). 1985. ASTHO Guide
to Public Health Practice: HTLV-III Antibody Testing and Community Approaches. Washington, D.C.: Public Health Foundation.

ASTHO. National Association of County Health Officials, U.S. Conference of Local
Health Officers. 1988. Guide to Public Health Practice: HIV Partner Notification Strategies. Washington, D.C.: Public Health Foundation.

Bayer, Ronald. 1989. Private Acts, Social Consequences: AIDS and the Politics of
Public Health. New York: Free Press.

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